Unfit for Residency

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Around the world governments are seeking to address the financial threat they see obesity posing to the wellness of their health care systems and New Zealand represents a new front in the war on obesity.

This article published with permission from The Burrill Report.

Albert Buitenhuis is a South African transplant in New Zealand, but apparently after six years of living among the Kiwis, the government is sending him a clear message: We don’t want your kind.

The 50-year-old chef and his wife came to the island nation six years ago on a visa that’s been extended several times, but his problems began when he applied for permanent residency. He’s not a convicted felon, a spy, or an advocate of the violent overthrow of the government. He’s just fat.

His story has received coverage around the globe from reputable news services. Buitenhuis, who reports place between five feet eight inches and five feet 10 inches, tips the scales at just under 287 pounds. He’s actually dropped a fair bit of weight since arriving in New Zealand. He says he’s down about 66 pounds since he moved to the country. But immigration authorities rejected his efforts to become a permanent resident because he was seen as a potential burden on taxpayers. He’s got a body mass index of 40 and New Zealand is setting its limit at 35.

A spokesman for New Zealand’s immigration agency told the BBC that Buitenhuis’ application was rejected because his obesity put him at “significant risk” of complications including diabetes, hypertension and heart disease.

“It is important that all migrants have an acceptable standard of health to minimize costs and demands on New Zealand’s health services,” the spokesman said.

Around the world governments are seeking to address the financial threat they see obesity posing to the wellness of their health care systems. In 2008, Japan passed a law that set a maximum on waistlines for people 40 and older (33.5 inches for men, 35.4 inches for women). Employers must measure their staff once a year and anyone who exceeds the waistline limit must get counseling. Employers who fail to reduce the number of overweight employees by 2015 by 25% face having to pay more into a health care fund.

In Europe, countries including Romania, France, Finland, Hungary, Belgium and Sweden have wrestled with implementing a so-called Fat Tax on certain foods, such as sugary drinks or trans fats. Denmark, which is credited with passing the world’s first fat tax in 2011, repealed it a year later. The unpopular tax, which hit not only junk food, but also high-end cheese, was seen as difficult to administer and sent shoppers across the border to buy their choice unhealthy foods.

And in New York City, Mayor Michael Bloomberg continues his efforts to legislate away excess weight. He’s imposed limits on trans fats and the sale of soda in restaurants and other outlets. He’s also pushing to make stairways more available in new and renovated construction to encourage people to become more active.

New Zealand represents a new front in the war on obesity. New Zealand has a problem. Some 27% of its population is obese, the third highest percent for a country behind Mexico and the United States. But it’s not going to solve its obesity problem by shipping it out one expanded waistline at a time. That isn’t a solution and does nothing to address its home grown problem.

Buitenhuis and his wife are facing a difficult situation. Because of their immigration status, they are no longer able to work. Since he is the principal applicant on the work visa under which they are both in the country, he and his wife are facing deportation. They are appealing their case.

But deeper questions remain for health care systems around the world: the debate over obesity as a disease or a behavioral problem, personal responsibility to maintain health when others pay for care, and the role and authority of governments to address lifestyle issues.

These questions, though present in the discussion around obesity, extend much further into issues of health and wellness. New Zealand has added some color to that discussion, but more in the way of punch lines than policy.